HORMONE REPLACEMENT IN MENOPAUSAL WOMEN

工作总结：截至1997年7月1日，已有106名妇女参加了 BLSA围绝经期研究已经完成了他们的第一个住院患者 评估和至少一个季度的GCRC门诊就诊。总计 已完成631次门诊，每位妇女从1次到16次不等。 年，13名妇女共完成了27次住院GCRC检查 夜间频繁采血。在这些女性中，有两人被归类为 围绝经期(基于卵泡刺激素的测量， 但她们距离最后一次月经还有不到两年时间。分析了 夜间生长激素分泌已经完成，数据来自10个 单次月经早、晚期绝经前妇女 周而复始。不同发育阶段的生长激素分泌无明显差异。 月经周期。对纵向数据的初步分析将是 当至少6名女性的血浆FSH水平较高时进行。再来两个 绝经前妇女同意在未来三个月内接受研究 以完成对15名女性的研究队列。 我们还分析了纵向骨密度(BMD)测量结果 在腰椎和臀部。27名绝经前(Pre)女性， 随访1岁(平均2.5岁)，平均年龄48.7±0.3岁。 他们与21名被归类为围绝经期(Peri)的女性进行了比较，这些女性在 至少一次就诊前0.3年(平均0.84年)和至少一次就诊1 在他们最初的高FSH值之后一年(平均1.90岁)。他们被跟踪了 平均2.7岁，平均年龄50.3±0.6岁。Pre组 脊柱骨密度显著增加，而Peri组有 显著下降。两组的骨密度值也分别为 有很大不同。Pre和Peri两组都输了 股骨颈和粗隆部位的骨头。根本没有 Pre和Peri在臀部的任何部位都有显著差异。 确认预期的椎骨加速丢失 围绝经期转变，而在围绝经期妇女中类似的髋部骨密度下降 而围绝经期妇女似乎无法区分，这表明 髋部骨折的风险可能在绝经后才会开始增加 句号。骨生物标记物的检测已经完成 访问量截至1997年2月1日。数据分析正在进行中，以确定序列 变化与骨密度的变化相关。 身体成分是由DEXA和人体测量学测量的。到目前为止， 21名留下来的女性有完整的身体成分数据 绝经前24人，定义为围绝经期 上面。没有测量的身体成分参数(体重、身体 体重指数、腰围、腰臀比、总脂肪质量 扫描，或脂肪百分比)在基线时，Pre和PERI组之间的方差分析不同。 佩里族妇女在估计中显示出显著的纵向增长 脂肪(总脂肪和脂肪百分比的DEXA)与前两组相比 以及脂肪分布指数(腰围)的差异 和WHR，p&lt；0.05)和血清瘦素水平(p&lt；0.03)，但不是体重 或者身体质量指数。这些数据表明，身体成分的变化 可能发生在绝经过渡的早期。

Summary of work: As of July 1, 1997, 106 women have been enrolled in the BLSA Perimenopausal Study and have completed their first inpatient assessments and at least one quarterly outpatient GCRC visit. A total of 631 outpatient visits have been completed, ranging from 1 to 16 per woman. A total of 27 inpatient GCRC visits have been completed by 13 women for overnight frequent blood sampling. Of these women, two are classified as perimenopausal (based on measurement of the follicle stimulating hormone, FSH) but they are within two years of their last menses. Analyses of nocturnal GH secretion has been completed for data obtained from ten of the premenopausal women during both early and late phases of one menstrual cycle. There was no difference in GH secretion in between phases of the menstrual cycle. A preliminary analysis of the longitudinal data will be performed when plasma FSH levels are high in at least 6 women. Two more premenopausal women have agreed to be studied within the next three months to complete the study cohort of 15 women. We have also analyzed longitudinal bone mineral density (BMD) measurements at the lumbar spine and hip. The 27 women who remain premenopausal (PRE), were followed > 1 yr (mean 2.5 yrs), and had a mean age of 48.7+/-0.3 yrs. They were compared to 21 women classified as perimenopausal (PERI),with at least one visit > 0.3 yrs before (mean 0.84 yrs) and at least one visit >1 yr after (mean 1.90 yrs) their initial high FSH values. They were followed an average of 2.7 yrs, and had a mean age of 50.3+-0.6 yrs. The PRE group had a significant increase in BMD in the spine while the PERI group had a significant decrease. The BMD values of the two groups were also significantly different . Both the PRE and the PERI groups were losing bone at the femoral neck and trochanteric region. There was no significant difference between PRE and PERI at any hip site.These data confirm the expected accelerated vertebral bone loss during the perimenopausal transition, whereas the similar losses of hip BMD in pre- and perimenopausal women appear not to be distinguishable, suggesting that hip fracture risk may not start to increase until the post-menopausal period. The assays to measure bone biomarkers have been completed for visits up to 2/1/97. Data analyses are underway to determine if serial changes correlate with changes in bone density. Body composition is measured by DEXA and anthropometrics. To date, complete body composition data are available for 21 women who remain premenopausal and 24 who are classified as perimenopausal, as defined above. None of the parameters of body composition measured (weight, body mass index, waist circumference, waist-hip ratio, total fat mass by DEXA scan, or % fat) differed by ANOVA between PRE and PERI groups at baseline. The PERI women exhibit significant longitudinal increases in the estimates of fatness (total fat and % fat by DEXA) compared with the PRE group as well as differences in indices of fat distribution (waist circumference and WHR, p<0.05), and in serum leptin levels (p<0.03), but not in weight or body mass index. These data suggest that changes in body composition may occur early in the menopausal transition.